Heart & Vascular Center of Arizona was one of 150 provider organizations that successfully attested to meaningful use of electronic health records on April 18, the first day that attestation was available under the Medicare incentive program.

The center, with six specialists serving the Phoenix region at five sites, learned a big lesson that most other providers will face as they seek meaningful use, says Barbara Watkins, administrator. "The No. 1 thing is to look at internal workflows and how data is being captured and recorded," she advises. "Your system isn't capturing and recording all the data you think it is."

Many providers, she explains, have used EHRs for several years and recently upgraded to meaningful use-certified systems. But the doctors still are using old "observation" terms that the upgraded system may not be capturing.

Heart & Vascular Center thought it was on course to meet medication reconciliation criteria because its patient portal enables access to a clinical summary of care, including a medications list.

But because the meaningful criteria specifically addresses transitions of care, all providers had to be trained to use a specific code to identify a post-op visit as a "transition of care" event. "That was a hurdle for us," Watkins says. "We had to stop what we were doing and make sure everyone was doing it the same way."

Another issue: Heart & Vascular Center could not select the menu measure of providing a Continuity of Care Document upon request, even though it offers the CCD via its patient portal. Patients can download the CCD from the portal, and even though most of the practice's patients are elderly, that's what they do. And their primary physicians can access specialists' notes following a visit. But the practice couldn't attest to providing the CCD upon request because they don't get requests--the patients just get the CCD themselves.

The practice expects to receive first-year meaningful use incentives of $18,000 for each of its six physicians. That doesn't come close to covering the cost of the Centricity EHR from GE Healthcare, but achieving meaningful use is worth the effort, Watkins contends. Patients are becoming more empowered and want their information. "They want to print it and print it at home."

Consequently, providers are going to have to become meaningful users, she believes. "I know it's just a cost of doing business now."

--Joseph Goedert

 

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